Tell HN: The disparity between employees and international contractors

7 points by throwwouq 4 years ago | 14 comments

I live outside the US and am a programmer in a US company. Starting this job two years ago coincided with a cancer diagnosis in the family. Treatment has gone well in private hospitals, but insurance doesn't cover oncology drugs, so we pay for them out-of-pocket.

We make around 110K USD a year combined, and have spent just under 200K on medical bills over these past 24 months. We have taken out loans to get by.

Public hospitals here are a mess and are almost always out of stock of oncology drugs, most radiation machines are out of service, etc. Combine that with sanitation malpractice and it's not somewhere where you would want a loved-one treated (even if they had the oncology drug, which they don't).

In hindsight, our family should have had private health insurance coverage that includes oncology drugs. None of the local insurance providers do this, so I've looked at international providers (Bupa, Allianz, BestDoctors, etc). My budget is so tight I can't really afford to sign up for one of these now, even though it might help prevent a repeat situation. Also, they won't provide much help for someone who already has cancer.

We've looking for ways to increase family income. I signed a non-compete with the company I work for, and I'd need to check in with them before starting anything extra. My partner is looking for a better paid job, but English is the big barrier to get a remote job like me.

I wish my current employer provided employee-sponsored health insurance for me and my partner. They do that for their US employees, but not for international contractors. In an ideal world they would also cover our dependents, which would include the family member who has cancer.

Countries like the one I live in have always had these problems. It's just that now as the world opens up to remote work, the difference in circumstance between one employee and the next can be great. While you might have dental, vision, health insurance, 401K matching, your teammate working out of a developing country might be struggling to pay hospital bills and have enough for basic necessities.

giantg2 4 years ago |

Sorry that happened to you. My family is dealing with multiple health issues too.

It might help if we know the country. Even US based contractors need to buy their own insurance. That's part of why contractors usually get a higher rate. $110k USD is likely to be a very large amount in your country, as it about 150% the median household income in the US.

throwwouq 4 years ago | |

> Sorry that happened to you. My family is dealing with multiple health issues too.

I'm sorry to hear that. What's worrying you the most at the moment with relation to the health issues?

> $110k USD is likely to be a very large amount in your country, as it about 150% the median household income in the US.

It is a very good income for this part of the world, and also a good income for the US as you say. While higher pay can get you part of the way, there's some things that it can't get in my experience. For example, if I take out private health insurance at Allianz, it doesn't cover pre-existing conditions. Company-sponsored health insurance does usually cover pre-existing conditions.

giantg2 4 years ago | | |

"I'm sorry to hear that. What's worrying you the most at the moment with relation to the health issues?"

The usual- costs, coverage, quality of life.

Are you sure nobody will cover it pre-existing? I saw Cigna has an international plan that might. It's likely the premiums will be very large. Maybe medical tourism could help with costs, like in Thailand.

On a side note, maybe it's possible to manufacture the drug yourself? I mean, what will the company do - sue someone who's already broke from paying for the meds?

I guess the other option is to find a different job, with a local company, that will provide insurance.

ratg13 4 years ago |

I am sorry for your misfortune, but I believe this to be misdirected.

(1) Employers offering Healthcare options to employees is more of a failure of the healthcare system in the US than a positive employment perk.

(2) Your company chooses the Healthcare provider they partner with. You are likely ineligible to be covered by their provider.

(3) Contractors do not get benefits. This has nothing to do with you being international. If you were based in the US, you would not be provided with Healthcare either.

All contractors in every country all over the world do not get employee benefits and is more or less the definition of being a contractor.

Either you are mistranslating some words, or seem to be missing some valuable pieces of information that is making you conflate all these variables.

It does bother me quite a bit though that you signed a non-compete agreement, as you typically only see this with employees.

(1) This is not enforceable (assuming of course you aren't reusing their work for other clients)

(2) As a contractor you are running a business. You are responsible for taxes, paying your salary, insurance, and Healthcare.

(3) Another company cannot dictate how you run your business. You can grow your business, take on new clients, do whatever you want.

It sounds like you need to do either one of two things.

(1) Start running your contractor setup more like a proper contractor shop. Get advice from here about expanding your business.

(2) If you really want to be an employee of a US company you can ask if they will sponsor you for a visa.

Hopefully my response has not been too direct, but I do think you need to get out of this mindset of thinking you are an employee. You are a contractor, and should be able to leverage the benefits of that. Most notably the larger incomes contractors demand for the simple fact they have so much more overhead to run their business.

Businesses in turn are happy to pay inflated contractor costs because it means they do not have to provide them with benefits like insurance.

These are two different ways of working and should not be equating them as you seem to be.

If you really want to be an employee, pretty much the only options are asking them to sponsor you for a visa, or getting them to open a branch office in your country.

I hope this gives you some thoughts to push things in one direction or another, and I hope that things turn in your favor this year.

throwwouq 4 years ago | |

Thanks for this, it's given me food for thought and options to explore.

> Employers offering Healthcare options to employees is more of a failure of the healthcare system in the US than a positive employment perk.

I think this is a failure in many countries including the one I'm in. Employee-sponsored health insurance seems to be the best workaround.

> Your company chooses the Healthcare provider they partner with. You are likely ineligible to be covered by their provider.

Fair, my employer's health care partner probably can't insure people outside the US. There are new health care providers that cater for remote companies and their employees [1] but I don't have a good understanding of how good their offering is.

> Contractors do not get benefits. This has nothing to do with you being international. If you were based in the US, you would not be provided with Healthcare either.

Good point. I'm not sure if my employer is treating me like an international contractor though. I have a boss, don't get overtime, can't work for other clients, signed a non-compete, etc.

The latter part of your response is fair. I think I got the mindset that I'm a de facto employee. I work on a team where everyone else is an employee and I don't seem to be treated differently. Here's where I think I need to explore alternatives and see what my options are.

[1] https://safetywing.com/remote-health

ratg13 4 years ago | | |

> I have a boss, don't get overtime, can't work for other clients, signed a non-compete, etc.

When you are a contractor you don't really have a boss. You have clients, you need to start getting yourself in this mindset, even though the end result ends up being more or less the same.

So again, no boss, but you have a representative from the company that you have a contract with that is your liason and the person that is giving you the work. You need to keep them happy like a boss, but they are not your boss.

You don't get overtime from the company because you are not an employee of theirs, you are employee of your own contracting business. It is up to you whether you pay yourself overtime or not.

Whether there is money available for this or not in the contract depends on how you negotiated the contract.

Regarding not being able to work for other clients, this is just not true. You are your own business and you can take on all of the clients you please. The documents you signed are meaningless and do not hold any water. Of course if you do take on work for other clients, you do not need to let your current customer know unless it will materially impact them in some way.

> I work on a team where everyone else is an employee and I don't seem to be treated differently.

This is normal for contractors. You work alongside regular employees and everyone is focused on the same goal. The only issue is that you need to not think of yourself like an employee. You work for yourself and you create the rules around how you operate your business.

I think what you need to do more than anything else is to talk with other contractors about how they deal with clients.

Get better information about how long they take contracts for, how many contracts they take at once, how they negotiate prices with prospective employers and what formulas they use to factor in external costs, ask them how they budget the money for their operations, how far they plan ahead, ask them how they do their own healthcare.

You need to take your business to the next level, and currently you seem to be allowing a customer to drag you around by the shoestrings to do whatever you want.

It's time to start setting some better rules around how you operate, instead of just going with the flow.

I believe getting this advice from other people who are currently do this is probably the best way to start.

waffle_maniac 4 years ago |

What country?

throwwouq 4 years ago | |

I'm in a developing country in South America. I'm avoiding mentioning it by name since my acquaintances are on here, it's a small country, and I want to stay anonymous.

GFischer 4 years ago | | |

You're making a lot of money... if it's Uruguay, it's unfortunate but yeah, most coverage excludes oncological drugs and public healthcare is also very backed up.

Not sure if you'd have a better outcome in the US, if anything you'd be WAY poorer.

A friend whose wife had cancer ended up going to a Sao Paulo clinic.